体位性睡眠呼吸暂停患者临床与多导睡眠图特征分析

Clinical and polysomnogram characteristics of postural sleep apnea patients

目的体位对睡眠呼吸暂停(OSA)产生不容忽视的影响。本文的研究目的是比较体位性OSA(POSA)和非体位性OSA(NPOSA)之间的临床特征及多导睡眠图(PSG)参数。方法共403例OSA患者纳入本研究,检查前完成临床资料采集和主观量表评估,包括Epworth思睡量表、Berlin问卷以及Stop-Bang问卷,记录睡眠实验室中403例患者的PSG参数,比较POSA组与NPOSA组之间的差异。结果170例受试者(42.2%)符合POSA的诊断标准,POSA患者的颈围和BMI均比NPOASA患者更低(P<0.05);POSA组N1期的睡眠时间显著缩短,但N2期、N3期、REM期睡眠时间更长(P<0.05);POSA组的AHI、微觉醒指数、腿动指数、周期性腿动指数均低于NPOSA组,且均有统计学意义(P<0.05或P<0.01);此外,NPOSA组清醒期和睡眠期最快心率较POSA更快(P<0.05)。结论POSA组和NPOSA组显示出不同的临床特征,且体位性OSA具有更好的睡眠结构,NPOSA组心脏可能承担更多的风险。

Objective Body position has a significant impact on sleep apnea(OSA).The objective of this study was to compare the clinical features and PSG parameters between postural OSA(POSA)and non-postural OSA(NPOSA).Methods A total of 403 OSA patients were enrolled in this study.Before examination,clinical data were collected and subjective scales(Epworth Sleep Scale,Berlin Questionnaire,and Stop-BANG questionnaire)were evaluated,and PSG parameters of 403 OSA patients were recorded in the sleep laboratory.The differences between POSA group and NPOSA group were compared.Results 170 subjects(42.2%)met the diagnostic criteria of POSA.The neck circumference and BMI of POSA patients are lower than those of NPOASA patients(P<0.05).In POSA group,the time in N1 sleep stage is significantly shortened,but the time in N2,N3 and REM sleep stages are longer(P<0.05).AHI,micro-arousal index,leg movement index and periodic leg movement index of POSA group are lower than those of NPOSA group,and the differences are showed statistically significant(P<0.05 or P<0.01).In addition,the fastest heart rate in POSA group is lower than that in NPOSA group in both waking and sleeping periods(P<0.05).Conclusions The results of POSA group and NPOSA group show different clinical characteristics.The POSA patients have better sleep structure,while the NPOSA patients have worse sleep structure and may bear more heart risks.